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 Half of older drivers interviewed for the AAA Foundation for Traffic
Safety study were taking seven or more medications, and one quarter
were taking 11 or more, researchers found.
And nearly one in five were taking medications the American
Geriatrics Society has called potentially inappropriate medications,
or PIMs. According to the society, these medications should be
avoided by seniors because they have very limited benefit, pose
excess harm, or both.
Most of these PIMs, which include benzodiazepines and some
antihistamines, have been shown to cause impairments, such as
blurred vision, confusion, fatigue or incoordination. Other research
has shown that these medications can raise the risk of a crash by up
to 30 percent, the AAA Foundation researchers note in their report.
Currently, 42 million adults age 65 and older are driving on U.S.
roads and the number is expected to increase substantially over the
next decade, according to AAA.
"The good news is that a lot of things can be done about this," said
Jake Nelson, AAA director of Traffic Safety Research and Advocacy.
"By working shoulder to shoulder with healthcare providers and
pharmacists we can mitigate the risks by letting older drivers take
the medications they need while allowing them to drive safely. The
bad news is that patients are not having the necessary conversations
with their doctors and pharmacists."
In fact, an earlier study found that "when it came to families
discussing driving behaviors with older members, 83 percent reported
they had never had a conversation," said Tara Kelley-Baker, data and
information group leader at the AAA Foundation for Traffic Safety in
Washington, DC. Another earlier study found that fewer than 2 in 10
older patients said they had received a warning from healthcare
providers about how their prescriptions might impact their driving.
For the new report, researchers from the AAA Foundation and study
sites in five states analyzed data from 2,949 seniors participating
in the AAA LongROAD study. When the seniors enrolled, they were aged
65 to 79 and were asked to put all their medications, including
vitamin and food supplements and over-the-counter drugs, in a bag
and bring them to be reviewed.
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Participants brought a total of 24,690 medications to the review
sessions. Overall, while 3 percent of participants took no
medications and 10 percent took two or fewer, 10 percent took 16 or
more and 1 percent took 26 or more.
Seventy-three percent of participants took at least one drug for
heart disease and 70 percent took a drug that affects the central
nervous system.
Of particular concern to the researchers were the medications that
were potentially inappropriate for older adults, which would include
drugs that impair physical or mental function, such as narcotic pain
medications, anti-anxiety medications like benzodiazepines and sleep
aids. Along with the potential negative effects on driving ability,
these medications are also associated with adverse effects, such as
hip fractures, depression and incontinence.
The researchers also note that the odds of an older adult falling
are 6 times higher if they are using 10 or more medications.
The bottom line on this study "is it confirms what a lot of
internists and geriatricians suspect," said Dr. Zaldy Tan, an
associate chief of geriatric medicine at the David Geffen School of
Medicine at the University of California, Los Angeles.
A big part of the problem is that older people often see multiple
physicians, said Tan, who was not involved in the new research.
Their physicians often don't know about all the medications a
patient is taking, just the ones they themselves prescribed.
Tan suggests older patients bring a list of all their medications,
as well as the reason each was prescribed, to their primary care
physician. "If they are taking more than 10 then I would start
looking very carefully to see if any of them can be taken away," Tan
said.
The foundation also offers a website (www.roadwiserx.com) where
users can check the effects and interactions of the medications
they're taking.
SOURCE: https://bit.ly/2P4lr0x AAA Foundation for Traffic Safety,
online November 28, 2018.
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